2. A New Global Health Crisis Chronic disease replacing communicable disease By 2020, chronic disease (heart and lung disease, diabetes and cancer) will account for 75% of all deaths worldwide Obesity, inactivity and poor diet have reached epidemic levels

3. A New Environment

4. Choice or response? Many people believe that we simply need to make better choices (it’s about ‘will power’) Individual choices are important – we all need to take more responsibility for our health Choices we make are shaped by the choices we have To have an impact, we must change the environment in which choices are made (it’s about ‘collective will’)

5. How does Nova Scotia Measure Up? Our health by the numbers…

6. Breastfeeding Breastfeeding is recommended exclusively for the first 6 months of life. Infants in Nova Scotia are breastfed less frequently and for shorter periods of time than the rest of Canada. Data Source: CCHS 2007-08 and 2009-10

7. Nutrition Not enough vegetables and fruit 4-6 servings a day of “other” foods (fats, oils, sugars, candy, etc.) Too much sodium 93-96% below minimum fibre intake Date Source: Keeping Pace 2009-10

8. Food Security Being “food insecure” means not always being able to afford safe, healthy food. Nova Scotians consistently report rates higher than average. Data Source: CCHS, 2009-10

9. Physical Activity % Meeting Minimum Guideline Data Source: Keeping Pace 2009-10 15-45% attend an after school program with physical activity 3 times a week. Less than 20% walk or bike to school in good weather.

10. Physical Activity Trends % Meeting Minimum Guideline *2009-10 results cannot be directly compared to previous years because the data is weighted to be provincially representative Data Source: Keeping Pace 2001-02, 2005-06, 2009-10 2001-02 2005-06 2009-10*

11. Sedentary Behaviour Screen Time % Exceeding Recommended Maximum of 2 hours/day Data Source: Keeping Pace 2009-10 Screen time was higher on weekend days.

12. Overweight and Obesity % Overweight or Obese Data Source: Keeping Pace, 2009-10

13. “Looking at the increasing rate of childhood obesity is like looking into the future health of Nova Scotians.” Dr. Keith McCormick Doctors Nova Scotia Health Promotion Section Chair Looking ahead…

14. How Do Adults Compare? More Overweight and ObeseLess Vegetables and Fruit % Eating Less Than 5 Servings/Day % Overweight or Obese (BMI>25) Data Source: CCHS 2009-10 (self-report)

15. Nova Scotia currently has the highest incidence of chronic disease in Canada – 1 st for heart and lung disease – 2 nd highest diabetes and hypertension – 1 st for multiple chronic diseases (co-morbidity) Much of this is preventable! Overweight and obesity cost the province $452 million in 2010. Based on current rates of increase, costs are estimated to total $9.5 billion over the next 10 years. Poor Adult Health Outcomes

16. Evidence review Discussion Framework and web site Engagement (June - Nov. 2011) – Government (forum June 2 nd ) – Task Teams (Healthy Eating and Physical Activity) – Stakeholders (100+ groups) – Online (900+ online submissions) – Scientific Advisory Panel What We Heard released on April 19 th Developing a Strategy

17. This is still seen as a “healthcare” issue Evidence is clear that it must be whole of government and multi-sector, but we’re not there yet (barriers and silos) Prevention is still not a priority – it’s seen as a “nice to do”. We need to value it more. We’re doing many of the right things – we need to celebrate, support, and expand “Right medicine, wrong dose” What We Heard

18. Address obesity by focusing broadly on health 40% of chronic disease can be prevented by focusing on common modifiable risk factors: – Poor diet – Inactivity/sedentary behaviour – Mental health/stress – Tobacco use – Alcohol use Thrive! is part of a broad prevention platform: – Tobacco, alcohol and mental health strategies; early years learning and care; public health renewal; sustainable transportation and other initiatives Our Approach

19. 75% of the factors affecting our health are outside the health-care system (e.g. education, income, housing) Health improves at every step up the socioeconomic ladder Countries with the smallest gap between rich and poor have better health outcomes – the gap is widening in Canada Strategy makes one recommendation: – Introduce a Health Impact Assessment (“health in all policies”) in public health legislation Foundation – Social Policy

20. "No ONE thing will ever prevent childhood obesity… or any obesity for that matter.” Dr. Yoni Freedhoff Obesity Expert Weighty Matters The “sandbag phenomenon” What will we do?

21. "No ONE thing will ever prevent childhood obesity… or any obesity for that matter.” Dr. Yoni Freedhoff Obesity Expert Weighty Matters The “sandbag phenomenon ”

22. Support parents and families in the early years –Best practice and clinical standards (e.g. WHO growth charts, maternal weight gain) –Accessible health information (e.g. Loving Care) Strengthen prevention in primary health care Encourage and support breastfeeding –Baby-Friendly Initiative ™ –Community grants –first6weeks online peer support

23. 2. Skills and Knowledge Increase food knowledge and skills –Curricula in schools –Programs that build knowledge and skills (e.g. cooking, school gardens) –Provincial food literacy plan Increase physical education and physical literacy –Professional development in regulated child care –Physical education in schools (QDPE) –Sport and recreation (swim and bike) Educate leaders –Training opportunities for new professionals

24. 3. Opportunities Make healthy food more accessible and affordable –Cross-government committee to develop policy options (food security, financial incentives and disincentives, food policy councils and local food) –Fat, sugar, sodium content of prepared foods (F-P/T) Support food policies in public institutions –Policies in schools, child care, DHAs, sport and recreation facilities, colleges and universities –Breakfast Program transition (Nourish Nova Scotia) –New facility funding to require healthy eating policy

25. 3. Opportunities (con’t) Decrease the influence of marketing to children and youth –National approach (voluntary) and provincial approach (policies in child care and schools) Increase physical activity and decrease sedentary time in child care and schools –Guidelines, resources, active learning Increase participation in after-school programs –New program for junior high (rural and remote) –Committee to coordinate provincial efforts –F-P/T funding and standards

26. 4. Healthier Communities

27. Leadership and Engagement

28. Measuring and Reporting

29. Outcomes

30. Budget

31. What Will Be Different?